| NPI | 1881861565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES BRIAN STEPHENS Owner / Dentist 847-864-8151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: IL 019019740) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: IL 019022119) |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2008-05-13 |